Lillian Au - Academia.edu (original) (raw)
Papers by Lillian Au
Medical Education, Feb 28, 2023
PRiMER: Peer-review reports in medical education research, Oct 19, 2021
Introduction: The objective of this study was to examine the mindsets (mastery, performance appro... more Introduction: The objective of this study was to examine the mindsets (mastery, performance approach, performance avoidance) of early-career family physicians following graduation from a competency-based education residency program. Methods: This was a longitudinal, cohort, survey study of family medicine residents at a large Canadian university. The 2015-2017 cohort of family medicine residents was surveyed at three time points: (1) at the end of residency training; (2) at 1 year in clinical practice; and (3) at 3 years in clinical practice. We used Baranik et al's instrument to measure three types of mindsets. We performed descriptive and multivariate analyses using SPSS 26.0 software. Results: Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P<.001). Over time, the mastery mindset scores tended to decrease (P=.04). Conclusion: Family physicians trained in competency-based education continued to be mastery-oriented in the brst 3 years of clinical practice. This bnding is reassuring given that the mastery mindset is associated with professional well-being and long-term success. Nonetheless, because mastery mindset scores appeared to decrease over time, residency programs need to ensure graduating residents are equipped with knowledge and tools to remain mastery-oriented throughout the course of their professional careers.
Family Medicine
Background and Objective: Residents-as-teachers (RAT) programs provide opportunities for resident... more Background and Objective: Residents-as-teachers (RAT) programs provide opportunities for residents to gain teaching skills. Published studies have assessed RAT programs largely at a single point in time rather than longitudinally. To address this gap, we examined (a) longitudinal trends in RAT participants’ interest, comfort, confidence, skill, and familiarity with aspects of clinical teaching; and (b) subsequent involvement in clinical teaching. Methods: We conducted a longitudinal survey of one cohort of family medicine residents (N=56) who participated in the RAT program during residency. We collected data before and after the RAT program and at one and three years into practice (2016-2020). We measured outcomes including interest, comfort, confidence, skill, familiarity with aspects of clinical teaching and involvement in clinical teaching. We performed longitudinal analysis using repeated measures analysis of variance. Results: Response rates at four data collections were 63% (...
Education and training
Context: A mastery mindset is important for physicians' engagement in lifelong learning. In prima... more Context: A mastery mindset is important for physicians' engagement in lifelong learning. In primary care, early-career physicians face unique challenges in establishing independent clinical practice following residency training. This study aims to shed light on whether family physicians graduating from a competency-based education (CBME) residency program continue to exhibit mastery-oriented mindsets and motivations that could have an impact on lifelong learning and patient care outcomes. Objective: To examine the mindsets of early-career family physicians following graduation from a CBME residency program. Design: Longitudinal, cohort, survey study of family medicine (FM) residents. Setting: One graduating FM resident cohort (2015-2017) at a large Canadian university was surveyed at three time points: 1) end of residency training, 2) one year into clinical practice, and 3) three years into clinical practice. Population Studied: Of 70 eligible FM residents, 52 (74%), 43 (61%), and 29 (41%) completed the questionnaire at each of the three data collection points respectively. Instrument: Baranik et al.'s instrument was used to measure the three types of mindsets (mastery, performance approach, performance avoidance). Each mindset was measured by 4 statements. Participants indicated their level of agreement with each statement (1=not at all agree; 10=completely agree). Main Outcome Measures: Three types of mindsets: Mastery-self-directed, intrinsic motivation towards learning; performance approach-motivation towards impression management; and performance avoidance-motivation towards ego-protection. Descriptive and multivariate analysis of variance were performed. Results: Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P < 0.001). With time, the mastery mindset scores decreased among the cohort (P = 0.04). Conclusions: Family physicians trained in a CBME residency program continued to be mastery-oriented in the first three years of clinical practice despite a downward trend. Residency programs need to ensure graduating physicians are equipped with knowledge and tools to maintain mastery mindset throughout their professional careers.
PRiMER, 2021
Introduction: The objective of this study was to examine the mindsets (mastery, performance appro... more Introduction: The objective of this study was to examine the mindsets (mastery, performance approach, performance avoidance) of early-career family physicians following graduation from a competency-based education residency program. Methods: This was a longitudinal, cohort, survey study of family medicine residents at a large Canadian university. The 2015-2017 cohort of family medicine residents was surveyed at three time points: (1) at the end of residency training; (2) at 1 year in clinical practice; and (3) at 3 years in clinical practice. We used Baranik et al’s instrument to measure three types of mindsets. We performed descriptive and multivariate analyses using SPSS 26.0 software. Results: Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P<.001). Over time, the mastery mindset scores tended to decrease (P=.04). Conclusion: Family physicians trained in competency-based edu...
Education for primary care : an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors, Jan 16, 2017
Family physicians regularly encounter clinical uncertainty and ambiguity and thus, are expected t... more Family physicians regularly encounter clinical uncertainty and ambiguity and thus, are expected to engage in on-going learning to respond to changing needs of family practice. Using Achievement Goal Theory, the objective of this study was to examine motivations for learning of family medicine residents in a competency-based program. This was a cross-sectional study, employing a survey methodology with family medicine residents at the mid-point of training at a Canadian university. Multivariate analyses of variance and covariance were used to examine residents' goal orientations (performance approach, mastery approach, performance avoidance, mastery avoidance) for the group as a whole and to test for the effects of residents' gender and program stream (urban/rural), respectively. A total of 52 (67%) residents completed the survey. Overall, residents scored highest on mastery approach and lowest on performance avoidance, thus, exhibiting adaptive motivations for learning. Male...
Medical Education, Dec 10, 2019
Context: Medical schools of geographically large nations have expanded into rural areas to facili... more Context: Medical schools of geographically large nations have expanded into rural areas to facilitate the development of a sustainable rural pipeline of physicians. Preceptor, or clinical teacher, recruitment at these sites has been an ongoing challenge. However, residents-as-teachers (RaT) curricula have not been modified to support the development of rural teachers. This study aimed to compare teaching opportunities between rural and urban family medicine residents and to identify mechanisms underlying potential differences. Methods: Year-1 and Year-2 family medicine residents at seven Canadian institutions participated in a mixed-methods study utilising a quantitative survey and a qualitative interview. Rural and urban residents rated the quantity and types of teaching opportunities available during their training, from which a chi-squared analysis was completed. Volunteer respondents participated in a structured interview, from which a thematic analysis was performed. Results: Rural family medicine residents had fewer opportunities to teach compared to their urban colleagues. This discrepancy was seen across multiple domains, including informal opportunities when on family medicine rotations, χ 2 (4, n = 242) = 45.26, P < .000, Bonferroni's adjusted P < .000. Thematic analysis centred around determining factors influencing teaching opportunities and identified that the academic context, personal factors and programme factors were key dimensions. Within these dimensions, the number of medical students, a desire to be an educator and administrative support were cited as influences on teaching opportunities. Conclusions: The lack of teaching opportunities for rural trainees is attributable to a combination of practical and organisational factors revealed through thematic analysis. If rural graduates are not comfortable balancing the demands of service and teaching, this could compound the already prevalent issue of rural preceptor recruitment. It is essential to develop a rural-focused RaT curriculum to close this gap and produce competent educators who are ready to inspire generations of rural physicians. 1 | INTRODUC TI ON Recruitment of physicians to rural areas continues to be a concern across many geographically large nations as inhabitants to these regions have poorer health outcomes, lower life expectancy and fewer physicians per capita. 1-4 Interventions targeted at physician recruitment have been multipronged and it is hoped that through a diverse strategy, a solution to this longstanding issue can be found. 5
Medical Education, Feb 28, 2023
PRiMER: Peer-review reports in medical education research, Oct 19, 2021
Introduction: The objective of this study was to examine the mindsets (mastery, performance appro... more Introduction: The objective of this study was to examine the mindsets (mastery, performance approach, performance avoidance) of early-career family physicians following graduation from a competency-based education residency program. Methods: This was a longitudinal, cohort, survey study of family medicine residents at a large Canadian university. The 2015-2017 cohort of family medicine residents was surveyed at three time points: (1) at the end of residency training; (2) at 1 year in clinical practice; and (3) at 3 years in clinical practice. We used Baranik et al's instrument to measure three types of mindsets. We performed descriptive and multivariate analyses using SPSS 26.0 software. Results: Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P<.001). Over time, the mastery mindset scores tended to decrease (P=.04). Conclusion: Family physicians trained in competency-based education continued to be mastery-oriented in the brst 3 years of clinical practice. This bnding is reassuring given that the mastery mindset is associated with professional well-being and long-term success. Nonetheless, because mastery mindset scores appeared to decrease over time, residency programs need to ensure graduating residents are equipped with knowledge and tools to remain mastery-oriented throughout the course of their professional careers.
Family Medicine
Background and Objective: Residents-as-teachers (RAT) programs provide opportunities for resident... more Background and Objective: Residents-as-teachers (RAT) programs provide opportunities for residents to gain teaching skills. Published studies have assessed RAT programs largely at a single point in time rather than longitudinally. To address this gap, we examined (a) longitudinal trends in RAT participants’ interest, comfort, confidence, skill, and familiarity with aspects of clinical teaching; and (b) subsequent involvement in clinical teaching. Methods: We conducted a longitudinal survey of one cohort of family medicine residents (N=56) who participated in the RAT program during residency. We collected data before and after the RAT program and at one and three years into practice (2016-2020). We measured outcomes including interest, comfort, confidence, skill, familiarity with aspects of clinical teaching and involvement in clinical teaching. We performed longitudinal analysis using repeated measures analysis of variance. Results: Response rates at four data collections were 63% (...
Education and training
Context: A mastery mindset is important for physicians' engagement in lifelong learning. In prima... more Context: A mastery mindset is important for physicians' engagement in lifelong learning. In primary care, early-career physicians face unique challenges in establishing independent clinical practice following residency training. This study aims to shed light on whether family physicians graduating from a competency-based education (CBME) residency program continue to exhibit mastery-oriented mindsets and motivations that could have an impact on lifelong learning and patient care outcomes. Objective: To examine the mindsets of early-career family physicians following graduation from a CBME residency program. Design: Longitudinal, cohort, survey study of family medicine (FM) residents. Setting: One graduating FM resident cohort (2015-2017) at a large Canadian university was surveyed at three time points: 1) end of residency training, 2) one year into clinical practice, and 3) three years into clinical practice. Population Studied: Of 70 eligible FM residents, 52 (74%), 43 (61%), and 29 (41%) completed the questionnaire at each of the three data collection points respectively. Instrument: Baranik et al.'s instrument was used to measure the three types of mindsets (mastery, performance approach, performance avoidance). Each mindset was measured by 4 statements. Participants indicated their level of agreement with each statement (1=not at all agree; 10=completely agree). Main Outcome Measures: Three types of mindsets: Mastery-self-directed, intrinsic motivation towards learning; performance approach-motivation towards impression management; and performance avoidance-motivation towards ego-protection. Descriptive and multivariate analysis of variance were performed. Results: Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P < 0.001). With time, the mastery mindset scores decreased among the cohort (P = 0.04). Conclusions: Family physicians trained in a CBME residency program continued to be mastery-oriented in the first three years of clinical practice despite a downward trend. Residency programs need to ensure graduating physicians are equipped with knowledge and tools to maintain mastery mindset throughout their professional careers.
PRiMER, 2021
Introduction: The objective of this study was to examine the mindsets (mastery, performance appro... more Introduction: The objective of this study was to examine the mindsets (mastery, performance approach, performance avoidance) of early-career family physicians following graduation from a competency-based education residency program. Methods: This was a longitudinal, cohort, survey study of family medicine residents at a large Canadian university. The 2015-2017 cohort of family medicine residents was surveyed at three time points: (1) at the end of residency training; (2) at 1 year in clinical practice; and (3) at 3 years in clinical practice. We used Baranik et al’s instrument to measure three types of mindsets. We performed descriptive and multivariate analyses using SPSS 26.0 software. Results: Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P<.001). Over time, the mastery mindset scores tended to decrease (P=.04). Conclusion: Family physicians trained in competency-based edu...
Education for primary care : an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors, Jan 16, 2017
Family physicians regularly encounter clinical uncertainty and ambiguity and thus, are expected t... more Family physicians regularly encounter clinical uncertainty and ambiguity and thus, are expected to engage in on-going learning to respond to changing needs of family practice. Using Achievement Goal Theory, the objective of this study was to examine motivations for learning of family medicine residents in a competency-based program. This was a cross-sectional study, employing a survey methodology with family medicine residents at the mid-point of training at a Canadian university. Multivariate analyses of variance and covariance were used to examine residents' goal orientations (performance approach, mastery approach, performance avoidance, mastery avoidance) for the group as a whole and to test for the effects of residents' gender and program stream (urban/rural), respectively. A total of 52 (67%) residents completed the survey. Overall, residents scored highest on mastery approach and lowest on performance avoidance, thus, exhibiting adaptive motivations for learning. Male...
Medical Education, Dec 10, 2019
Context: Medical schools of geographically large nations have expanded into rural areas to facili... more Context: Medical schools of geographically large nations have expanded into rural areas to facilitate the development of a sustainable rural pipeline of physicians. Preceptor, or clinical teacher, recruitment at these sites has been an ongoing challenge. However, residents-as-teachers (RaT) curricula have not been modified to support the development of rural teachers. This study aimed to compare teaching opportunities between rural and urban family medicine residents and to identify mechanisms underlying potential differences. Methods: Year-1 and Year-2 family medicine residents at seven Canadian institutions participated in a mixed-methods study utilising a quantitative survey and a qualitative interview. Rural and urban residents rated the quantity and types of teaching opportunities available during their training, from which a chi-squared analysis was completed. Volunteer respondents participated in a structured interview, from which a thematic analysis was performed. Results: Rural family medicine residents had fewer opportunities to teach compared to their urban colleagues. This discrepancy was seen across multiple domains, including informal opportunities when on family medicine rotations, χ 2 (4, n = 242) = 45.26, P < .000, Bonferroni's adjusted P < .000. Thematic analysis centred around determining factors influencing teaching opportunities and identified that the academic context, personal factors and programme factors were key dimensions. Within these dimensions, the number of medical students, a desire to be an educator and administrative support were cited as influences on teaching opportunities. Conclusions: The lack of teaching opportunities for rural trainees is attributable to a combination of practical and organisational factors revealed through thematic analysis. If rural graduates are not comfortable balancing the demands of service and teaching, this could compound the already prevalent issue of rural preceptor recruitment. It is essential to develop a rural-focused RaT curriculum to close this gap and produce competent educators who are ready to inspire generations of rural physicians. 1 | INTRODUC TI ON Recruitment of physicians to rural areas continues to be a concern across many geographically large nations as inhabitants to these regions have poorer health outcomes, lower life expectancy and fewer physicians per capita. 1-4 Interventions targeted at physician recruitment have been multipronged and it is hoped that through a diverse strategy, a solution to this longstanding issue can be found. 5